Schaub C R, Farhi D C
Institute of Pathology, Case Western Reserve University, Cleveland, OH 44106.
Arch Pathol Lab Med. 1988 Jun;112(6):656-7.
Two children with advanced Wilms' tumor and one with extensive nephroblastomatosis showed artifactually elevated white blood cell (WBC) counts due to circulating mucin. Wilms' tumor is known to produce mucin identifiable in serum, urine, and touch imprints. To our knowledge, circulating mucin has not been described in nephroblastomatosis. When patients' blood was mixed with lysing reagent in the Ortho ELT-800, mucin was precipitated by acetic acid; this was confirmed by microscopy. Precipitates were counted as nuclei, producing abnormal WBC counts and histograms. When measured by the Ortho ELT-8/ws using osmotic lysis, the WBC counts matched hemocytometer counts. Mucin was not seen on Wright-stained smears but was evident with alcian blue staining and was largely abolished by hyaluronidase. Treatment led to disappearance of the artifactual WBC elevation.
两名患有晚期威尔姆斯瘤和一名患有广泛性肾母细胞瘤病的儿童，由于循环黏液素导致白细胞（WBC）计数出现假性升高。已知威尔姆斯瘤会产生可在血清、尿液和触摸印记中识别的黏液素。据我们所知，肾母细胞瘤病中尚未描述过循环黏液素。当患者血液与Ortho ELT - 800中的溶血试剂混合时，黏液素会被乙酸沉淀；这通过显微镜检查得到证实。沉淀物被计为细胞核，从而产生异常的白细胞计数和直方图。当使用渗透裂解通过Ortho ELT - 8/ws进行测量时，白细胞计数与血细胞计数器计数相符。在瑞氏染色涂片中未见黏液素，但阿尔辛蓝染色可见，且经透明质酸酶处理后大部分消失。治疗导致假性白细胞升高消失。
